This application relates to a medical-surgical apparatus and, in particular, to an apparatus for facilitating the replacement of a stoma bag for those people having had surgical operations for removing a bladder or colon.
In surgical operations, such as a colostomy where the colon is removed, or a cystostomy where the bladder is removed, the colon or ureter is rerouted so that waste material may exit through an artificial opening in the body known as a stoma. A stoma is connected directly to the kidney by a rerouted ureter or to the intestines by the rerouted colon and the discharge of waste matter in each instance is made through the stoma.
The new artificial opening, or stoma, made on the abdominal wall into the large bowel and termed a colostomy, has no voluntary sphincter control by the patient. In order to avoid involuntary bowel movement through the stoma, it is customary and desirable for the patient periodically to take an enema, commonly called irrigation, through the stoma. The frequency required of this irrigation is generally daily, or perhaps every second day, in order to keep the bowel free from involuntary discharges. Thus, any ostomy appliance which the patient may wear must necessarily be removed at least as often as irrigation is required.
Collection of involuntary waste seepage is by bag or other receptacle attached to the body of the patient. Good examples of such a receptacle for use after a colostomy are those taught in U.S. Pat. Nos. 2,561,906, 2,575,063 and 4,054,140. In general, these waste receptacles are mounted on a sealing ring which itself is adhesively secured to the body. It is essential that this ring be mounted directly and concentrically over the stoma and further, that it be tightly secured to the body, otherwise leakage of waste onto the surrounding skin area can occur. During removal and replacement of the ostomy appliance it becomes imperative that the area to which the ring is attached is kept surgically clean in order to prevent dermatitis which might result from contact of the skin with the waste material for a period of time. Also, it is important to prevent infection of the stoma which can lead to serious consequences. Should waste material be present on the skin prior to application of the adhesive for securing the ring, the skin-ring bond will fail, causing the waste receptacle and ring to loosen its attachment to the skin and spill its contents, in addition to causing dermatitis, infection or the like at the adhesive-skin interface. Thus, the adhesive serves as a sealant in the connection of the ostomy appliance to the stoma, as well as a bonding agent in the bag-ring-skin interface.
In the replacement of the ostomy appliance, the general procedure is first to remove the ring and the receptacle. A standard rolled 4.times.4 cotton gauze pad or tampon is then placed on top of the stoma to absorb any waste material and prevent it from leaking on the surrounding skin prior to the application of the adhesive. The surrounding skin must be cleaned and dried. This is generally accomplished by the use of a commercially available "prep" agent, which removes the skin oils, cleans, and leaves a dry skin surface. On the application of the adhesive, the gauze is removed from the stoma and a ring is placed over the stoma in a precisely centered position. Generally, one must remain in a standing position and using a mirror to achieve the centered position. The ostomy appliance is then attached to the ring and tightly secured to the skin.
In the past, the gauze has been rolled to such a size as will admit the ring to be placed over the stoma without prior removal of the gauze. Should the gauze be removed during the placement of the ring, waste material can leak out necessitating the recleaning of the entire skin area about the stoma and the entire procedure must be begun anew. It becomes apparent that in the replacement of an ostomy appliance that the ring must be centered on the stoma and that the area immediately surrounding the stoma and in contact with the ring must be clean and dry during the replacement of an ostomy appliance.